Yes! Let’s talk about hormones (if we’re experts in the field)


I usually avoid writing when I’m on leave but y’know sometimes you see something and you get the rages, and as a colleague said to me yesterday as we raged to each other – sometimes right is just right. And so you respond.

You respond knowing full well that this is a head above the parapet situation. We’ve all heard of cancel culture, online attacks, threats. It’s moving closer to home for me recently. People I know personally and professionally have been, are being targeted. Good people whom I know to be skilled, caring professionals. Who have at the centre of their practice, their LIVES in fact, the care and wellbeing of their child and adolescent clients and patients.

What is happening to our culture that people like this are fair game for slurs, threats and attacks? Where is the quest for dialogue, compassion, patience, understanding and knowledge?

Anyway, there’s a piece I read in The Irish Examiner, a paper that proudly states it is in “pursuit of the truth”. Great motto.

So one wonders why they printed this:

And this is the “controversial” (ie grotesquely misunderstood) Irish Times article to which she refers, although I do still wonder if she actually read it…:

Bill to ban conversion therapy poses problems for therapists

Forcing sexual orientation shifts must be outlawed but gender identity needs focus”

This is true, yes? Conversion therapy is vile. And gender identity needs attention. Click To Tweet

Especially now, given that those of us who work with teens seem to be awash with concerns from children, teens and parents who are struggling to make sense of gender, gender questioning and the anxieties surrounding these issues.

We are navigating truly uncharted waters. Can we please not drown??

There was much response to Ms O’Donoghue’s piece. And here is mine. It hasn’t been published, although I did submit it. Maybe it will be, maybe not. But here is it. And I’m posting it here because I am shocked that the article was published and while this site isn’t the busiest ever hosted by wordpress, hopefully just even one or two parents will read it and decide to seek out more evidence based information before running for hormonal treatments for their child.

I agree – LET’S talk about hormones, but please, only if we are experts…

Re: Caroline O’Donoghue: Let’s talk about hormones

Dear Mr Fitzpatrick,
I am writing in response to the above article. I am deeply troubled by the contents therein.

The author asserts  that  “In the abstract, I  understand what these therapists are trying to say. It seems to come from the ‘but what if I say the wrong thing’ school of fear. Which, in today’s news climate, I understand. But the argument has many gaping holes in it.”

If indeed she does understand, it is difficult  to understand why she follows with the proposition that the article to which she refers comes from the “what if I say the wrong thing school of fear”. While this school is, as we all know, gaining thousands of enrolees by the minute, particularly within the dangerous confines of this “discussion”, that is  certainly not how the Irish Times article came across to me. 

There are no gaping holes. But there are several in Ms O’Donoghue’s piece. 

The Irish Times article was written by Jacky Grainger with the care of gender questioning youth in mind. Just that. Purely that. Irish therapists who work with gender questioning teens are not simply worried about saying the wrong thing. They, we, are concerned about the medical and psychological care of our young people, first and foremost – trans, or otherwise. The wording of the bill to which the article refers needs to change so that what we do in therapy is not conflated with or described as conversion therapy, one of the most outdated and abusive forms of intervention ever to have existed. And so we are concerned that what we do will be attacked as wrong and misunderstood as conversion. And that a result of this might be that trans youth or gender questioning children don’t get to access the care they deserve.

It seems we have good reason to be concerned. 

I don’t know your personal experience of therapy, nor do I know of the experience of Ms O Donoghue. 

But I refer to her words:   “I don’t know if therapy is supposed to challenge you in the way the article is suggesting. If I said to my therapist “I think I might be gay” and they responded with “sure, lookit, we all think Cate Blanchett is lovely, you’re only a bit curious”, or even “perhaps this Cate Blanchett thing has more to do with your mother than you being gay?”, I don’t think I’d come away feeling as though I had good therapy. I’d want my therapist to ask me to describe how I felt. I would want them to ask me questions, so I could access deeper regions of how I felt but hadn’t realised yet”. 

 This suggests that perhaps she doesn’t understand the therapeutic process. Or perhaps she’s had a very poor experience of therapy. That happens, sadly. But is she seriously suggesting that a trained therapist would respond with this level of dismissal and disrespect? 

Of course she’s right – questions and understanding – exploration – are key elements of good therapy. Essential elements. This Cate Blanchett analogy left me perplexed – what was the purpose of writing that, I wondered? I can only conclude that she, like the others she mentioned,  has misinterpreted completely the letter written by Jacky Grainger, a therapist who is accredited, and experienced in working with gender questioning and LGBT youth.

What a pity she didn’t simply ask. 

She goes on to talk about puberty blockers and sadly, she is quoting pseudoscience.  In short, she is wrong. She is wrong about the process, the effects, the reversibility of those effects, and the ability of therapists to prescribe.  One wonders where she did her “research” and one despairs that it got past editorial. 

Did she interview some actual therapists? Biologists? Endocrinologists?
She is not the first journalist to make these mistakes and conflations of course. It is rife, and I’m not naive. But I grow more and more disheartened that there seems to be a wilful ignorance of the complexities of teen development, gender dysphoria and of  the  (relatively new) science of hormonal treatments.  There is a shocking amount of misinformation and fear mongering out there and, as you surely know,  it’s gaining traction in recent years. 

Think of the 4000% increase in young girls identifying as trans in the UK alone. 

Her comparison of going on the pill in 2006 to puberty blockers in 2021 is a poor construct, and a straw man. 

Yes, people are afraid they’ll say the wrong thing. No one wants to invite online abuse or cancellation.  Because other people respond like this woman has in her piece,  all the while claiming to “ understand”  and claiming to be advocates.  I have seen people  being labelled as transphobic for simply asking questions – people who are genuinely trying to understand and support fellow human beings. 

What have we become?? 

And as you well know in your position as editor,  writers, scientists and experienced front line professionals like therapists and psychologists are being attacked, fired, threatened on a daily basis for sharing facts. Evidence based facts of science,  as we know them thus far. Not opinions. 

How sad to think that a piece written by those who care and advocate for our youth is being misunderstood and the authors demonised like this.  It is exhausting to continue to work and try to advocate for young people in the face of this vile hatred and sea of misinformation.

How sad to think that you support them by publishing articles like this.

I would respectfully ask that you consider publishing a retraction on the grounds of misinformation at the very least. This article and it’s misleading assertions may cause unwitting parents or teens to embark upon a journey that may not end well.

So my challenge to you is be an advocate for young people. A true advocate. She is  right, “Trans people need us to see them clearly”.  I will add –  all of our young people need to be seen. Trans, and trans questioning. That takes time, compassion, curiosity and great care.  And she’s right again when she says –

“Let’s not pretend to be blind again.” 
Sally O’Reilly 

If you’re interested in seeing a reasoned and well thought out twitter thread response look below. I was thrilled to have found this last night:

Right, that’s it for now. Sorry, it was a long one. Going back to my time off. I have a few hours of holidays left!

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